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Home My WebLink AboutPermit Demolition 1981-01-09- LI LICATICOMBITI Job Address EIIERGY SOURCES Hea t l,Jater Heater Range l-eqal Description 0wner Value of l,lork 5q. Ftg. Access Sq. Ftq. 0ther I'lew Add Al ter--IeD.- lence Derno Cha-nqe/Use -0ther- . l.lain Phone Buiicing Pernrit Info: Oeicn'Oe HoTt<-fFamily Residence l,li th Atiached-dirnd .e., Build Single .{, Cons >Q_ Addres s Phone n DO oee addre s s I (lics. no.)exoi l"es phone no.' Structura I Pri ma E I ectri ca I l'lechani cal Genera l Pl umbi no Electrica'i Itechani ca I PLUIlB I NG EL ECTR I CAL MECHAN I CAL lic-l FEE CHARGE NN FFF C HARGF I'10 FFF CHARGF Each singie fjxture Residence of ETSQ furnace/burner to BTU' S Relocated bui lding (new fix. additional ) New ci rcui ts al ts.or extensions Floor furnace and vent S. F. Residence ( I uattr)SERV I CES Recessed wal I Soace heater and vFnf Duplex (1 bath) each Additional bath Temporary Constructi on Apo'1 iance vent sepa ra te l.later servi ce res i dence Change in existing Stationary evap cool er Sewer multifamily, comrn I ndustri a I or Vent fan with sinole duct Storm Sewer 0f amps.Vent systen apart from heatinq or A.C, coMl.l./IND. FEEDERS Mechanical exhaust hood and duct Insta l I /al ter/rel ocatedistrib. feeders ['Jood stove/heater 0f amps ISSUANCE OF PFRI1IT TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES tlAl'lE(please print)S IGI]ATU DATE V WHERE STATE LAtl REQUIRES that the Electrical work be done byshall not be valil until the label has be'en signed by an Electri, an Electri ca1 Supervi cal Contractor, the electrical portion of this permit sor and returned to the Building Division fy fyany rd I E eI tedhet c La ocomp for t an he reddoappDerm l rtCC I th at a 1I n1 tforma onib.y reonhe si ruetc0rdanrec t dan fu rthe r c er L tha at nd 1a Iaf_v l{o kr rformedpe has II be I ndone a rdcco cean thwl heL na0rdi snce ciofthe tySr1fiofedIdanethwsLaof Lny ofpngtheLdSte n'I n1 to eth kwor ioe rta g descr hbed re ni0regon and th ta itn YOCCUPAI,IC Iwl beI madeofructtwlurethoustthess'I on,l ofpe rm the IBu dI i ,lD 'I s cIngfurther ert ,1 th ta 5'I t ra onti thY,lI the IU deI r sre-qm.yBoasIn'I Ufr II fo drcean e tffec as ,lu red 701ORS 0s5 tha 'It freqby t Udhe 'i foS EXr ti onxempt not heed reo n tand haemp t0nSntru bco ac to1y rs and I whos 'Iempoyeeare n 'I'I cean thwi a0t?s 0comc 1 505 ItJ't I be sedu n .Ith s tproj ec Flood Plain Stories Occ.y Group Sq. Ftg. 0ther x Val e/Const ToTAL VALUATT0N=-- Val ue Zone Fire Zone Bedrooms Ftg. AccessLoad Uni ts ValueFtq. l'lain Plan Ck. Conm/Ind 65"1/B1do Ppr Fpp Svs Cha tems Deve rqe (1.5% 0pmentBUILDING PERNIT Charges and Su rc harges Plan Ck. Res 30%/Bldq Per Fee FencePLUI4BING PERMIT Charges and Surcha rges Demo SidewalkELECTRICP.L PERI1IT Charges and Surcha rges To tal C.ornb . Permi tA/C Paving Curb Cut I II NECHANICAL PERMIT Charges and Surcharges TOTAL /)anr adapyss f ion ly'naei - u '.oo PERMIT VALIDATION Permi t Cl erk COMBiNATION APPLICATION/PERMIT (CAP) i. Applicant to furnish A. Job Address B. Legal DescriPtion 1. example- Tax Lot 100, Lane County Map Reference 17 03 43 2. example- Lot 1. Block 3, Znd Addition to SFffigField Estates C. Name, etc. of owner and construction lender D. Energy Sources 1. example- heat/electrical ceil ing/or fgrced air gas2. exarnElE- waterhEITEiTEIEEtrIWor soTar E. Square footage or vajuation, etc. i. examole- Elq sq. foot house, 500 sq. foot garage ?. exa;ple-r lT-new project, check new - if addition, EfEcI- add, etc.F. Building permit informatjon: 1' example - construct single family house with an attaci',ed garage 2. examole - remode'l existing garage 'into family room 3. gr.rFlE - convert single family residence into restaurant (change of use) G. Value of work as defined in Sect.ion 303 (a) of the Structural Specialty CodeH. DESIGN TEA|'I AND CONTRACTORS To avoid design or construction delays, Building Division Staff must be able to contact appropriate persons regarding design information or job site corrections, etc. IL Abbreviated Plurnbing, Mechanical, & Electrical SchedulesA. [xcept where blank spaces occur in the description portion of the Mechanical and Electrical Schedules, the applicant. need fill-in only the No. Boxes adjacent to the appropriate item(s) to be installedB. Full Piumbing, l'lechanicai, and Electrical Schedules are avaiiable at the Building Division1. To conserve space on the permit form the schedules have been abbreviated ?. If the item(s) to be installed are not covered on the abbreviated schedules you should consult thefulI schedulesC. BUILDING DIVISION STAFF IiiILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULESD. As noted on the CAP, the iabel must be de'livered to the eiectrical contractor for signature by his electrical supervisor. The general contractor is no! authorized to sign the electiical labelIII. Applicant-to sign and date llhenever possible, the initial application wiil be used as a worksheet only. Where possible, Building Division Staffwill prepare a type written copy and return it to the app)icant at the time the actual permit is issued for his s i gna tu re.IV. Fees and Charges PIan check fees are due and payable at the time of the application, and no plans will be processed until these fees are paid. All other fees and charges are due and payable when the permit is issued. V. FOR OFFICE USE ONLY PROJECT CONDITIONS TO BE SATiSFIED BEFORE OCCUPAIICY: Permit applicant exempt from r.egistrat'ion with the Builder's Board because: Add'itional Project Information : PLANS REVIEWED BY dates i gnaturename COIlB I TI ON l'la i n Owner CAT I ON RMIT l-egal Description Job Address llater Heater Val ue of t./ork Ranqe 69 iON LII{E 5q. Ftg. Access.._--- Sq. Ftq. 0ther _l.lew_Add_AlierjAp. - _Fenc e_Demo_Cha n ge/ U s e 0ther EIIERGY SOURCES Hea t Phone Builciin Farni I y g Pernrit Info: Describe L,lork( Residence I'lith Attached Garrle .e., Build Single onL der )p Addres s Phone I o4 c e o DESIGN TEAI1 namg ( addre s s I (l-l cs . no.exoi [^es phone no Struc tura I Pri ma El ectri ca I Hechanical n ame address exDl res I P1 E ectri ca I PLUIIS I IIG ELECTR I CAL 14ECHAN ICAL FFF alrAoctr NO FFF I]HARGF it0 -FFF r:HAPGF Each single fixture furnace/burner to BTLI' S Relocated buiidino (new fix. additioial ) New circuits alts. or extensions Floor furnace and vent S . F. Res i dence(l bath)SERV I CES Recessed wa l I Soace heater and vFnt Duplex (l bath) each Additional bath Temporary Constructi on Apol i ance vent sepa rate l,later service ge in existing dpncp Chan res i Stati onar,v evap cool er Sewer multifamily, comm IndustriaI 0r Vent fan with si nol e duct Storm Sewer 0f amps.Vent systenr aoart from heatinq or A.C. COI"1I.l./IND. FEEDERS Mechanical exhaust hood and duct- InstaI I /aI ter/re l ocatedistrib. feeders l'Jood stove/heater amps0f ISSUANCF OF PFRI{IT I,lAi'iE(piease print)IGiIATURE an Res TE e{ So Sq X k d an I . 0ther x Va Flood Plain Stories Occ.y Grou lueP So. Fto rge 5t QUitSt.lHERE AT LlI,JTE RE RESI ttha Ithe e 'Ictr Ica rkwo rttEIanbenedoec Ica n traCo toc r the ec'I ctri 'Ia I of0n hitport s L.IDermIshaInotVAbe1juIIbehaithentbe'enS s 1 an Ei ec bytri ac Ignedby Su srvr andor dDEreturne theLU '|Bu dI 'I I 'I 1s onng any rd YI EX the I Ica o,I n fo rcomp t nda doap!')oerm Ice rt T tha t a n'I rmatfo on'I I svre0nhe t eruanddancoLrrecthe r LIcerrfui ndathat a II workfy rmed Iha Iperfo be nedo nI ordaacc enc wl th t 0rdhe na1 esnc of tofS he L 'Ie'I di andDrtng the ofLaws tyany oftatetheS rta0 'I 'Ireq0n theto rkl^/Os de rtc bed nherei nda th La NC OCC YUPAI,IC t II beof made5turetrucwithouthetrmipe'Iss no of the iBu dI 1 Di vi s on'I fu hert cerr 1t tha t re s'I trfym.y ,a It no th1,r'l tBoag he uB II rde ssIn1Ifu1foarcendeffeasctnq 70 1requredORS 05 5 tha Lby sI t bathe i frexemDss0 r 'I on tedno hn0Iexempt ereon an d Lnts ubco rac t ha t-v 0rs dan Iernp rvho rea ,loyees n 1 a'|nCcomD twi h 0i?s 707 Etr I$,I I be edus th0n 'I S ctero,jp al ue Zone TOTAL VALUATION Tyoe/ Con st.Uni ts Load tems Deve TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES BUILDING PERI,IIT Charges anC Su rcha rges Ftg. Access . Ftg. l4ain x ValFire Zone Bedrooms Occy PLUI1BING PERMIT Charges and Surcha rges Fencq Dgmo ELECTRICAL PERIIIT Charges and Surcha rges Sidewalk A/C Paving Total Comb. permit Curb Cut IIECHAIIICAL PER14IT Charges and Surc ha rges TOTAL ll,M tddrpss f 7)Al ,I '{echa n i ca'l ';: ) Residence of SQ. FT. Loo COIIBINATION APPLICATiON/PERMIT (CAP) I. Applicant to furnish A. Job Address B. Legal Description 1. examole- Tax Lot 100, Lane County Map Rel 17-03-[:.. 2. examole- Lot 1. Block 3, 2nd Addition to Sprffigfietd EstatesC. Name, etc. of owner and construction lenderD. Energy Sources 1. examo_le- heat/electrical cefling/or force2. eyemcJe- waterFe-aTEiTElEETiJiIJTor soTf'F-E. SquarE rootage or valuat,ion, etc.1. examcle- 149. sq. foot house, 500 sq. foo2. exallple- lT--new project, check-i6w - if a check aod, etc.F. Bui )ding permi t information:1. examole - construct sin_o1e fami)y house w;ttacned garage 2. exanole --rem6del existing garage into far3. examplE - convert single iafrily-residence restaurant (change of use)G. Value of work as defined in Section 303 (a) otStructural Specialty CodeH. DESIGi.I TEA|.I AIiD CONTRACiORS To avoid design or construction delays, Buildi0ivision Staff must be able to contact appropr persons regarding design information or job sicorrections, etc.IL Abbreviated Plumbing, i'lechanicai, &A. Except vrhere blank spaces occuroortion of the ilechanical and E the applicanr need fill-in oniy Electrical Schin the descrip lectrical Sched the No. Boxes III IV. PERMIT VALIDATION CITY oF SPRINGFIEtD ( CirY Holl Springfield, Oregon Deportment of Public Works OFFICIAL RECEIPT to the appropriate item(s) to be inEtalledB. Fuil Plumbjng, Ilechanical, and Electrical Sche are avai lable at the Building Division1. To conserve space on.the permit form the sr have been abbreviated2. If the item(s) to be installed are not covr the abbreviated schedules you should consu' ful I schedul esC. BUlLDING DIVISION STAFF WILL FILL OUT ALL FEES CHARGES ON THE SCHEDULESD. As noted on the CAP, the label must be deliverrelectrical contractor for signature by his elecsupervisor. The generai contractor is not autito sign the electrical label Applicant to sign and date llhenever possible, the initial app)ication will be a worksheet only. 'vlhere possible, Buiiding Divis'ionill preoare a type written copy and return it to t applicant at the time the actuai permit is issued f signature. Fees and Cha r_oes PIan check feis are due and payable at the time of h.application, and no p)ans wili be processed until these fees are paid. All other fees and charges are due and payable when the permit js issued. V. FOR OFFI CE USE O|.ILY N I 0. B 55554 9 Ad I ived Fo Amount Received THORIZEO SIGNATURE PiINIEFS EUG€NE OR E74O! t ( i. i. / ( (: (,. ('' G, (.t (, (B (* (g ,:,8 ,A '..8 (g :a (,L-r a(l Permit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI.ICY: Permit applicant exempt from registration with the Builder's Board because: Additional Proiect Information: PLANS REV I EI^IED BY : date name Si gnature (r